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CONSTRUCTION LIEN <br />CJ) <br />(1) <br />.J <br />0) <br />-H <br />s) <br />rte) <br />co <br />.. <br />rV <br />) <br />ry <br />rn <br />c:J <br />Return <br />to: DJ'S HEATING AIR CONDITIONING AND ELECTRICAL INC <br />1. The real estate subject to this lien is 2212 N SHERIDAN GRAND ISLAND NE 68803 <br />400100460 UNIVERSITY PLACE S 23.38' LT 11 & ALL LT 13 BLR 12,1bC3 <br />2. The person against whose interest in the real estate the lien is claimed is JAMES AND STACY SIMMERMAN <br />ON 1N3WIT1SNl SY 031131N3 <br />00 <br />ortiroJiti <br />1 .5141A4 <br />it a taaaly <br />Aikr/ikw <br />3. The name and address of the claimant is: DJ'S HEATING AIR CONDITIONING AND ELECTRICAL INC <br />2917 CIRCLE DR GRAND ISLAND NE 68801 <br />4. The name and address of the person with whom the claimant contracted JAMES AND STACY SIMMERMAN <br />2212 N SHERIDAN GRAND ISLAND NE 68803 <br />5. A general description of the claimant's services performed or to be performed or materials furnished or to be <br />furnished for the improvement of INSTALLATION OF NEW FURNACE AND AIR CONDITIONER <br />6. The total contract price is: $4942.71 <br />7. The amount unpaid, whether due or not, to the claimant for services or materials is $ 2600.00 <br />8. The date the last services or materials were furnished was 07/22/2019 <br />Claimant: <br />/ r , .r i 11. <br />State of Nebraska, County of <br />_ o_ of i r s I rj Qir l li�lanin t ei!Gfx/� <br />. The foregoing instrument was acknowledged before me this 3 day/n' <br />9 9 9 � <br />GENERAL NOTARY - State of Nebraska <br />TRACY L OVERSTREET GARTNER <br />My Comm. Exp. October 27, 2020 <br />Jit <br />fracul L. Ove��+reef Gar -f -M( <br />Printed No ry Name <br />My Commission Expires: 10 7 -0-0a-0 <br />State of Nebraska, County of I.-\ �, . The foregoing instrument was acknowledged before me this 3d day <br />f t (C(A. 20 O, by <br />it s}kah, t,� <br />/J.41 4 <br />ary P ;,r ignature <br />lu4iJII) /�%jo,(ar,L i <br />'''�eTg gal fres a corporation, on behalf of said corporation. <br />V?L4 1..- OU2ree " Gar1-vur <br />Printed Not ry Name <br />la GENERAL NOTARY - State of Nebraska <br />1 TRACY L. OVERSTREET GARTNER <br />irswOjoRit My Comm. Exp. October 27, 2020 <br />My Commission Expires: i' O 7 ?C' <br />